07 Hernia

• inhale, diaphragm moves down and closes structures/bowels, herniation

3 locations

• diaphragm where esophagus pokes through

• umbilicus

• inguinal

Femoral Structure

• inguinal ligament between superior iliac spine and pubic symphysis

• find femoral artery by feeling for pulsation. Medial is vein. Lateral is nerve

• look down from top

• femoral ring contained in vein that carry lymphatics

• femoral sheath contain vein, artery, ring

Inguinal Canal

• on top of inguinal ligament

Hernia

Indirect

• testes form within process

• opening should seal

• develop in adulthood with years of bearing down

Direct

• indirect in spermatic cord, fascia

• direct outside spermatic fascia

• transversalis fascia weak and breaks down

Femoral

Ventral Hernia

Hiatal Hernia

• obesity: stomach forced up

• GE junction slides up

• phrenoesophageal membrane in diaphragm not sealed

• gurgling in stomach heard in abdomen

Diaphragmatic Hernia